In a recent publication in the journal Menopause, researchers conducted a real-world study and sought to examine the correlations of hormone preparations with lumbar spine bone mineral density (BMD), osteopenia, and osteoporosis in postmenopausal women and to determine if these impacts continued after hormone preparations were discontinued.
This study examined data from 6,031 postmenopausal women from the 1999 to 2018 National Health and Nutrition Examination Survey. The participants were divided into various groups focused on the types of hormone preparations used. Among them, 1,983 women did not use hormone therapy; 614 used estrogen-only pills; 72 used estrogen/progestin combination pills; 23 used estrogen-only patches; four used estrogen/progestin patches; 1,166 used two types of hormone preparation; and 224 used three or more types of hormone preparation. Of these, 1,996 participants were allocated further into current users [CU] recorded as (n = 743), or past users (PU; n = 1,253).
The researchers employed multivariable linear or logistic regression models to examine the associations of hormone preparation with lumbar spine BMD, osteopenia, and osteoporosis.
The results revealed a positive correlation with lumbar spine BMD (all P <.05) was observed with combined oral contraceptive pills, estrogen-only pills, estrogen/progestin combo pills, estrogen-only patches, or using more than two types of hormone preparations. Additionally, except for estrogen-only patches, other hormone preparations also had a protective effect against osteopenia (all odds ratios [ORs] <1, all P <.05), but none of them were correlated with osteoporosis prevalence (all P >.05). The BMD was also augmented by 0.10 and 0.04 g/cm2 in the CU and PU groups, respectively, compared with the nonuser group (all P <.05). Lastly, among both the CU and PU groups, the risk of osteopenia was diminished (OR, 0.34 and 0.57, respectively).
Based on their findings, the authors wrote, “Our study indicated that various hormone preparations increase lumbar spine BMD in postmenopausal women and have a protective effect against osteopenia, and these impacts persisted after HT was discontinued.”
The authors also noted, “Hormone preparations, however, were not associated with osteoporosis prevalence. Hormonal preparations altered the natural history of the three-stage decline in postmenopausal lumbar spine BMD to a linear decline, but the absolute value was greater.”
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Published July 11, 2023
